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GUIDELINES ON PREPARING FINANCIAL STATEMENT

OF LIFE INSURANCE COMPANY

I. GENERAL

1. These financial statements are made specifically for the purpose of providing

guidance and supervision of insurance business. Thus, the form, content, and

structure of financial statements are prepared in accordance with prevailing

regulations in insurance business (Statutory Accounting Practices / SAP) as

stipulated in the Ministerial Regulation of Minister of Finance No. 53 of 2012 and

its implementing regulations.

2. Content and structure of the Life Insurance Company Financial Statements are as

follows:

A. Key Financial Statement consisting of:

1) Statement of Financial Position of Life Insurance Company

2) Comprehensive Profit/Loss Statement of Life Insurance Company

3) Cash Flow Statement of Life Insurance Company

4) Statement of Changes in Equity of Life Insurance Company

5) Report of Solvency Level of Life Insurance Company:

a) Solvency Ratio Attained

b) Minimum Risk-Based Capital § Schedule A - Asset Mismanagement Risk

§ Schedule B - Mismatch between Projected Flow of Asset and

Liabilities Risk

§ Schedule C – Mismatch between Values of Asset and Liabilities in

Foreign Currencies Risk

§ Schedule D –Insurance Liability Risk

§ Schedule E –Interest Rate Risk

§ Schedule F –Reinsurance Risk

§ Schedule G – Operational Risk

6) Calculation of SAP Assets and Liabilities in Life Insurance Company

a) Sub A - Investment Placement Not In An Entity

b) Sub B - Investment Placement in Entity Affiliated with the Company

c) Sub C - Investment Placement in Entity Unaffiliated with the Company

d) Sub D - Investment Placement Overseas

e) Sub E – List of Affiliated Companies

7) Details of Financial Statement of Life Insurance Company

B. Additional Financial Statement, consisting of:

1) Guarantee Fund Statement in Life Insurance Company

a) Summary and Calculation of Guarantee Fund Adequacy

b) Details of End Position of Guarantee Fund

2) Financial Soundness Ratio other than MMBR

3) Training and Education Cost Ratio

4) Matching of Assets and Liabilities

5) Details of Premium Revenue and Claim Expenses based on Distribution

Channel

3. The form, content, and structure of financial statements shall be used both for

quarterly and annual financial statements.

4. For Life Insurance Company that does not meet the solvency criteria, the format,

content, and structure of financial statement shall be the same with the format,

content, and structure of quarterly financial statement.

5. For Companies that do not meet the solvency level, in addition to submit a report on

the Financial Restructuring as referred to in point 4, financial restructuring plan and

measures should be enclosed.

6. The key financial statements are presented sequentially for the two periods, i.e. the

current year period and the previous period. For the quarterly report, which referred

to the previous period, is the same period in the previous year. For example, to report

second quarter of 2013, the current period is the second quarter of 2013, while the

previous period was the second quarter of 2012. As for the annual report, which

referred to the previous period, is a period before the current period, for example, to

report in 2013, the current period was in 2013, while the previous period is the year

2012.

7. If there are rows or columns to be filled, but the value is 0 (zero) or none, then write

down 0 (zero).

8. Figures in the all format of financial statements shall be written in millions of rupiah

with two (2) decimal digits after the decimal point.

9. Negative numbers shall be marked in parentheses (xxxx).

10. Admitted Assets, hereinafter referred to as AYD, are permitted assets that are

measured to calculate solvency margin as referred to in the legislation in insurance.

11. Unearned Premiums Reserves, hereinafter abbreviated CAPYBMP, is a fund that

should be established to describe the part of insurance premiums period that has not

been completed.

12. Life Insurance Company (the Company) is the insurance company as defined in the

laws on insurance business.

13. Others

a. The company’s name must be written clearly on each title format. On the front

page (cover) the name and address of the General Insurance / Reinsurance

Company must be provided on the line available (XYZ in PT XYZ refers to the

name of the company).

b. The period of quarterly and annual financial statements shall be specified in

accordance with the ending date of the period reported. For example, report of

second quarter of 2013 is specified As Per June 30, 2013, while report of the year

2013 is specified As Per December 31, 2013.

c. If the company adds details pages, the pages are to be numbered a, b, and so on.

For example, Details 101 consists of two pages, then the first page shall be

numbered page 21a and continue to 21b, and so on.

d. Financial statements must be signed by at least one director and be presented in

company profile (page ii).

e. Company statement must be signed by at least one director representing the

company's directors.

f. Form, content, and structure of the financial statements can not be changed,

unless otherwise stated in the notes that are available in each forms. If the

number of lines or pages provided are not sufficient then the company can add

as needed.

g. In all forms, some important notes are placed to provide guidance on how to fill

out the form.

h. The financial statements cover page for General Insurance Company/

Reinsurance Company shall be red.

14. The flow chart on how to complete the financial statement format to calculate the

solvency level is as follows:

II. KEY FINANCIAL STATEMENTS

1. Statement of Financial Position

Statement of Financial Position consists of Statements of Financial Position prepared

under Financial Accounting Standards (SAK) and Statutory Accounting Practice (SAP)

which are presented together with the Statement of Financial Position for the previous

period as a comparison. Accounts in the Statement of Financial Position are filled out

!

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Y e s !

Y e s !

S t a r t !

D e t a i l s !

1 0 1 . 2 0 9 !

D e t a i l s !

3 0 1 . 4 0 3 !

D e t a i l s !

5 0 1 . 5 0 6 !

R i s k . b a s e d !

M i n i m u m !

C a p i t a l !

S c h e d u l e ! A . H !

D e t a i l s !

1 0 1 . 1 1 6 !

S u b ! D !

S u b ! B !

A f f i l i a t i o n !

w i t h !

C o m p a n y !

!

S u b ! C !

N o !

A f f i l i a t i o n !

w i t h !

C o m p a n y !

S u b ! E !

L i s t ! o f !

A f f i l i a t e d !

C o m p a n i e s !

S u b ! A !

S A P ! C a l c u l a t i o n ! o f ! A s s e t !

a n d ! L i a b i l i t y !

S A P ! A s s e t ! C a l c u l a t i o n !

S A P ! C a l c u l a t i o n ! o f ! A s s e t !

a n d ! L i a b i l i t y !

S A P ! L i a b i l i t y ! C a l c u l a t i o n !

S A P ! S t a t e m e n t ! o f ! F i n a n c i a l !

P o s i t i o n !

( P a g e ! 1 , ! C o l u m n ! 5 ) !

R e p o r t ! o n ! S o l v e n c y ! L e v e l !

( P a g e ! 5 ) !

C o m p r e h e n s i v e !

P r o f i t / L o s s !

C a l c u l a t i o n !

I n v e s t m e n t !

i n ! !

O n e ! E n t i t y !

O v e r s e a s !

i n v e s t m e n t !

N o !

N o !

based on the accounts listed in Details 101 up to 404.

a. SAK Statement of Financial Position

Accounts in this Statement of Financial Position has been reclassified in line with the

purposes, so that accounts should not be the same as the accounts in SAK statement.

The purpose of including SAK Statement of Financial Position is to provide

comparable figure for the accounts of SAP Statement of Financial Position, especially

for assets, making it easier for analysts to perform their analysis.

b. SAP Statement of Financial Position

The assets included in the SAP Statement of Financial Position are the AYD

(Admitted Asset), and accounts are filled out based on the accounts in Details 101 up

to 209. The amount of AYD for each type of asset is calculated based on the

applicable regulations. The AYD in this report (column (4)) is then entered into the

Report of Solvency Level - Solvency Ratio (column (2)) on AYD line.

Liabilities in the SAP Statement of Financial Position shall be filled out with accounts

listed in Details 301-402. The amount of liability in this report (column (4)) is entered

into the Report of Solvency Level - Solvency Ratio (column (2)) on Liabilities line.

For equity, accounts shall be adjusted as possible to the format provided. "Difference

of Value in SAK and SAP " account shall be filled out based on the amount in the

SAP Assets and Liabilities Calculation – Difference in SAK and SAP Valuation,

whereas “Non-admitted Assets” account is filled out according to the amount on SAP

Assets and Liabilities Calculation - I. SAP Asset Calculation column (5)

Difference in SAK and SAP Valuation may arise because of differences in the

valuation of assets and liabilities based on SAK and SAP. Asset valuation differences

between SAK and SAP arise because of differences in the recognition of asset value.

In general, SAP recognizes the asset at fair value whereas SAK recognizes an asset at

historical cost. For liabilities, difference may arise because SAK provide some choices

in the method to calculate technical reserves, which enables the Company to choose

SAK calculation method that is different from the calculation of technical reserves as

stipulated in the legislation.

In the event of any discrepancy between the SAP and SAK valuation of assets and

liabilities, the difference may increase or decrease SAP equity. Differences may occur

because SAP valuation of assets generally generates a greater amount of value than the

SAK valuation of assets, which consequently increase SAP equity. For liabilities, in

general, the Company will use SAP valuation that can provide a smaller value than

SAK liability valuation, which consequently increase SAP equity.

Whereas Non-admitted Assets may arise because of limitation in recognition of the

Company's assets so that not all assets recognized under SAK can be recognized as

asset based on SAP. Thus, the non-recognition of these assets would reduce SAP

equity.

Presentation of reinsurance assets in the Statement of Financial Position is presented

as asset that forms part of the AYD reinsurance receivables and are included as

admitted asset in the calculation of financial soundness. Reinsurance asset value

consists of:

§ The value of reinsurance assets on liability for future policy benefits is

determined consistently with the approach used in determining the liability for

future policy benefits, based on the terms and conditions of the reinsurance

contract.

§ The value of reinsurance assets on unearned premiums is determined

consistently with the approach used in determining the unearned premiums,

based on the terms and conditions of the reinsurance contract.

§ The value of reinsurance asset on estimated liabilities claims is determined

consistently with the approach used in determining the estimated liability

claims, based on the terms and conditions of the reinsurance contract.

2. Comprehensive Profit/Loss Statement

The columns in this report are filled out based on the numbers listed on Details 501-

506. SAP Comprehensive Profit/Loss Statement may be different from SAK

Comprehensive Profit/Loss Statement due to the different treatment of recognition

(technical reserves expense) and differences in the classification of accounts.

Classification of accounts for SAP reports is adapted to the existing provisions. Thus

the final result of the Comprehensive Profit / Loss (i.e. profit or loss) may differ

between SAP report and SAK report.

Comprehensive Profit/Loss Statement presented is the profit/loss statement for the

Comprehensive Statement from the start of accounting year up to the reporting date

(cumulatively). For example, for report of second quarter 2013, the income recorded

is the income earned since 1 January 2013 to 30 June 2013.

Increase (Decrease) of Premium Reserve, CAPYBMP (Unearned Premium Reserve)

and Decrease (Increase) of Claims Reserves in Comprehensive Profit/Loss Statement

is presented based on Details 501 and Details 504.

The component used to determine Gross Premium in this report is the gross premium

as referred to in Government Regulation No. 73 of 1992 concerning Insurance

Business as amended by Government Regulation No. 63 of 1999.

3. Cash Flow Statement

Statement of Cash Flows in this report is based on information filled in the space

provided in the format. Cash and bank closing balance in item number 45 at the end

of previous period (annually, quarterly and monthly) shall be the opening balance in

item number 1 for the current period. Cash and bank closing balance at the end of this

report should be equal to the amount of cash and bank in the Statement of Financial

Position.

4. Statement of Changes of Equity

Changes in equity consist of SAK and SAP equity. To fill out SAP statement of

changes in equity, the company must first fill out SAK statement of changes in

equity.

SAP Statement of Changes in Equity is a reconciliation of SAK Equity Reports into

SAP Equity report. Two of SAP equity components that are not equity components

under SAK, "Difference in SAK and SAP Valuation" and "Non-admitted Assets", are

two important components that affect the result of the reconciliation. Both

components are filled out in the SAP Statement of Changes in Equity only in the

amount of difference between the current period and previous period. Figures filled

into SAP Statement of Changes in Equity is an increase or decrease of "Difference in

SAK and SAP Valuation" and "Non-admitted Asset" as provided in column (5) and

column (7) of the Statement of Financial Position.

Example:

a. If the "Difference of SAK and SAP Valuation" listed in Statement of Financial

Position amounted to Rp 1,200 million in the first quarter of 2013 and Rp 1,000

million in the fourth quarter of 2012, the "Increase (Decrease) of Difference of

SAK and SAP Valuation" is Rp 200 million.

b. If the "Non-admitted Assets" in the Statement of Financial Position amounted to

Rp 5,600 million for the first quarter of 2013 and amounted to Rp 4,000 million

the fourth quarter of 2012, the "(Increase) Decrease of Non-admitted Assets" is

equal to (Rp 1,600) million.

5. Report of Solvency Level

Report of Solvency Level in this statement includes:

a. Solvency Ratio

The Company must meet minimum solvency level of 120% of minimum risk-

based capital as defined in the Regulation of the Minister of Finance No.

53/PMK.010/2012. The solvency referred consists of AYD and liabilities (except

subordinated loans).

Total AYD (column (3)) shall be equal to the amount of assets in the Statement of

Financial Position (column (5) – SAP Balance). Total liabilities (column (3)) shall

be equal to the amount of liabilities in the Statement of Financial Position (column

(5) - SAP Balance).

b. Minimum Risk-Based Capital

Instruction to fill in the Schedules in Financial Statements of Non-Life Insurance

Company/Reinsurance Company is as follows:

Schedule A: The total AYD (column (2)) shall be equal to the amount of assets in

SAP Statement of Financial Position (column (4)).

If the company has balanced mutual funds, then the sample

calculation of weighted average is as follows:

Securities Portfolio Composition Factor Average

Government bonds 40% 0% 0%

Corporate bonds 40% 6% 2.4%

Equity securities 20% 16% 3.2%

The weighted average of each security is the result from

multiplying the composition of each security with risk factors. In

the example above, the weighted average of balanced funds is the

sum of the weighted average securities portfolio, which is 5.6%.

Schedule B: The columns in this schedule are filled with the value of AYD and

liabilities based on book value in the Statement of Financial

Position that are grouped by maturity. AYD in the form of

securities traded and valued at market value (e.g. shares) are

classified as assets maturing in less than 1 (one) year. While the

AYD intended to be held to maturity are classified in accordance

with the remaining life.

Schedule C: Total AYD in line 14 column total (3) to (11) must be equal to the

amount of assets in SAP Statement of Financial Position, as well as

liability in line 22 total column (3) to (11) must be equal to the

amount of liabilities in the Statement of Financial Position

(excluding subordinated loans).

Schedule D: The columns in this schedule are filled in accordance with the

instructions provided in the format.

Schedule E: The columns in this schedule are filled in accordance with the

instructions provided in the format.

Schedule F: The columns in this schedule are filled in accordance with the

instructions provided in the format. If companies do not have a

deposit or retained premiums (column (4)), this column is filled

with 0 (zero).

Schedule G: General and administrative expenses as well as training and

education expense are filled with those expenses within a year. For

quarterly reports, general and administrative expenses as well as

the training and education expenses are filled with those expenses

in the last four (4) quarters. For example, for the first quarter of

2013, general expenses and administration is filled with a total

expense of the second quarter of 2012, the third quarter of 2012,

fourth quarter of 2012, and the first quarter of 2013. The same

applies for training and education expense.

6. SAP Assets and Liabilities Calculation

a. SAP Asset Calculation

Columns in SAP Asset Calculation (page 12) are filled in according to the

following guidelines:

Column 3: filled in accordance with what is stated in the details of each asset to the

total balance in general ledger (SAK).

Column 4: filled in accordance with the basis of valuation as stipulated in Minister

of Finance Regulation No. 53 of 2012.

Column 5: is the difference between column (4) and column (3).

Column 6: filled with the amount of non-admitted assets as contained in each

Detail (101 up to 209), especially for accounts on other investment,

other fixed assets and other assets.

Column 7: filled from total AYD contained in each Detail (Details 101 up to 209).

For cash and bank, the amount should be equal to the amount of

closing balance of the Cash Flow Statement.

Difference of amount between SAK and SAP Valuation (column (5)) is an

increase or decrease of equity of SAP Statements of Financial Position as

explained earlier in the Statement of Changes in Equity. The extra margin of the

valuation of assets based on SAK and SAP is an increase SAP equity, while lesser

margin of the valuation of assets based on SAK and SAP is a decrease of SAP

equity.

b. SAP Liabilities Calculation

Columns in SAP Liabilities Calculation are filled in according to the following

guidelines:

Column 3: filled in accordance with what is stated in each detail of liability for the

balance in general ledger (SAK).

Column 4: filled in accordance with what is stated in each detail of liability under

SAP valuation.

Column 5: filled based on the difference between SAK and SAP valuation

contained in each detail of liability (if there are differences between

SAK and SAP valuation).

The extra margin of SAP liability valuation based on SAK is a decrease in SAP

equity, while less margin of SAP liability valuation on SAK is an increase in SAP

equity.

c. Difference between SAK and SAP Valuation

The Difference between SAK and SAP Valuation used in preparing SAP

Statement of Financial Position is the net difference in the difference between the

valuation of assets and liabilities. This figure is then transferred to column (4) in

the statement of financial position in the account on difference between SAK and

SAP valuation.

d. Sub-Sections

Asset calculation form has 5 (five) sub-sections, namely:

1) Sub A, Investment Placement Not in An Entity

The columns in the Sub A are filled out when the Company placed an

investment in companies that are not affiliated either with company or non-

Company

2) Sub B, Investments Placement in Entity Affiliated with the Company

The columns in the sub-B are filled in if the company placed investment in

companies that are part of an affiliated group in which the Company is a part

of. Investment in the companies mentioned shall be maximum 10% (ten

percent) of the total investment.

3) Sub C, Investments Placement in Entities Unaffiliated with the Company

The columns in Sub C are filled in if the company placed investment in

companies that are part of an affiliated group, in which the Company is not a

part of. Investment in the companies mentioned shall be maximum 20%

(twenty percent) of the total investment.

4) Sub-D, Investment Placement Overseas

The columns in the Sub-D are filled when the Company placed investment in

countries other than the Republic of Indonesia.

5) Sub E, List of Affiliated Companies

The columns in the Sub E are filled in accordance with the information

provided in the format. The relationship of ownership (column (3)) is filled by

specifying the Company's position in the affiliated group. For example, as

subsidiary, parent company, and so on.

7. Details

7.1. Details 101

For this details the following conditions apply:

• Column (3) is filled with the bank's ratings. For banks that issue bonds,

bank ratings may refer to the rating issued by agencies listed in the

Financial Services Authority (Pefindo, Fitch Indonesia and ICRA

Indonesia). If the bank does not issue bonds and are not listed on the rating

agency indicated, this column does not need to be filled.

• Column (4) is filled with the clusters corresponding to the rank in column

(3). If the column (3) is empty, then this column is filled with the largest

cluster (cluster 5).

• The figures in column (7) is transferred to Details 601

• Column (8) is filled as follows:

1) If there is a placement of more than one type of investment

in a company, this column is filled by specifying the other

types of investment, such as "shares".

2) When this type of investment in the details is placed on

affiliated company, this column is filled with "Name of

Affiliated Group".

7.2. Details 102


• Column (3) filled as follows:

1. LQ45 or JII, in accordance with the category of shares.

2. Other than LQ45 and JII.

3. Foreign market.

• The figures in column (6) is transferred to Details 601


1. If there is a placement of more than one type of investment in a

company, this column is filled by specifying the other types of

investment, such as "corporate bonds".

2. When this type of investment in the details is placed on affiliated

company, this column is filled with "Name of Affiliated Group".

3. When this type of investment in the details is placed overseas, this

column is filled with "Overseas" and their total value is transferred to sub

D.

7.3. Details 103


• Column (3) filled with the rating of corporate bonds and sukuk issued by

rating agencies registered in the Financial Services Authority (Pefindo, Fitch

Indonesia and ICRA Indonesia) or who have international reputation

(Standard & Poor's, Moody's, AM Best, Fitch and ICRA).

• Column (4) is filled with clusters corresponding to column (3).

• The figure in column (8) is transferred to Details 601


1. If there is a placement of more than one type of investment in a company,

this column is filled by specifying the other types of investment, such as

"shares".



3. When this type of investment in the details is placed overseas, this

column is filled with "Overseas" and their total value is transferred to sub

D.

7.4. Details 104

• The columns in this Details are filled in accordance with the information

provided in the format.

• The figure in in column (6) is transferred to details 601

7.5. Details 105

• Column (3) is filled with a rating of investment instruments based on agency

that has international reputation (Standard & Poor's, Moody's, AM Best,

Fitch, and ICRA). The total value of these instruments is transferred to sub

D.

• Column (4) is filled with cluster corresponding to column (2).

• The figure in in column (8) is transferred to details 601

7.6. Details 106

• The columns in these details are filled in accordance with the information

provided in the format

• The figure in column (6) is transferred to details 601

7.7. Details 107

• The columns in these details are filled in accordance with the information

provided in the format and the total value of these instruments is transferred

to sub D.


7.8. Details 108


• Determination of categories of grouping for mutual funds should be based on

the actual composition of mutual fund investments on the reporting date of

the Statement of Financial Position, instead of the composition of

investments in the prospectus.

• A mutual fund is fully called as government bonds if 90% or more of the

composition of mutual fund investments are placed in government bonds. If

placement in one type of investment is less than 90%, the funds are grouped

as balanced funds. This applies also to the placement in other categories of

mutual funds.


• Column (7) filled as follows:



"shares".



3. When this type of investment in the details is placed overseas, this column

is filled with "Overseas" and their total value is transferred to sub D.

7.9. Details 109


• Column (3) is filled with a rating of investment instruments.

• Column (4) is filled with clusters corresponding to the column (3).





"shares".



7.10 Details 110


• Column (3) filled with a rating of investment instruments.

• Column (4) is filled with clusters corresponding to the column (3).





"shares".



7.11 Details 111


• For Column (7), the total maximum value is 10% (ten percent) of total

investment.




"shares".



3. When this type of investment in the details is placed overseas, this column

is filled with "Overseas" and their total value is transferred to sub D.

7.12 Details 112


• Category of buildings with the strata-title rights or land with buildings as an

investment or own-use shall be determined by the company, noting that the

building with the strata-title right or land with buildings can be categorized as

investments when they can deliver gains (rent) to the company.

• Column (2) is filled by specifying the city (DATI II) in which the building

with strata-title rights or land with building are located.


• Column (4) is filled using the value set by the appraisal agencies registered

with the authorities, or the latest taxable value (NJOP) in the case there is no

assessment by appraisal agencies

• Column (5) represents the difference between column (3) and column (4) for

each unit.

• Line No. IV (AYD) will be equal to total (I + II + III) if the total value (I + II

+ III) is less than or equal to 10% of the total investment.

7.13 Details 113


• Column (3) is filled with the license number of financing company and / or

bank.





"shares".



7.14 Details114


• This type of investment is in the form of gold bullion.

• Column (3) filled in accordance with the quantity of ownership. For example,

the Company has 10 kg gold bars; the column (3) is filled: 25 pieces/100gr,

10 pieces/250gr, 50 pieces/100gr

• The columns on these details are filled in accordance with the information



7.15 Details 115

• The columns on these details are filled in accordance with the information



7.16 Details 116

The columns on these details are filled in if the Company has investments other

than those that have already been mentioned above.

7.17 Details 201


• For details of the debtor, the debtor's to be detailed are those that owe the

company as much as 5% or more of the total value of premiums receivable.

Debtor that owe less than 5% of the total value of premiums receivables will

be categorized in "Other/Miscellaneous".

• For the category of debtors as "Insurance Broker", the total premium

receivable to the brokerage firm is filled out, so that the debtor name listed is

the name of the brokerage firm.

• The figure in column (5) may be greater than the figure in column (4),

considering receivable that can be inserted into the column (4) has a lifespan

that is shorter than those in column (5). Further, the figure in column (5) is

then transferred to details 601.

7.18 Details 202



company as much as 5% or more of the total coinsurance claim receivable.

Debtor that owe less than 5% of the total value of coinsurance claim

receivable will be categorized in "Other/Miscellaneous".

• Column (3) filled with a rating of debtors.


• The figure in column (7) may be greater than the figure in the column (6),




7.19 Details 203



company as much as 5% or more of the total reinsurance receivable. Debtor

that owes less than 5% of the total value of reinsurance receivable will be

categorized in "Other/Miscellaneous”.

• Reinsurance assets are part of the reinsurance receivable and included in

AYD.

• Column (3) filled with a rating of debtors.






7.20 Details 204


• Categorized as AYD is a receivable with a maximum age of one (1) month.


considering a bill that can be inserted into the column (4) has a lifespan bill is

shorter than the bill that can be inserted into the column (5). Furthermore, the

existing number in column (5) is then filled into the details of 601.

7.21 Details 205


• Which can be categorized as AYD is a bill with a maximum age of one (1)

month.

• The existing number in column (5) may be greater than the amount present in

column (4), considering receivable that can be inserted into the column (4)

has a lifespan that is shorter than those in column (5). Further, the figure in

column (5) is then transferred to details 601.

7.22 Details 206


• Loan in the current period shall be filled out for policy loan incurring in the

reporting period (new policy loan) by specifying the number of insurance

policies (details by policy only apply for non-APL policy loan)

• Details by policy only apply for quarterly report. For annual report, fill out

the total increase of policy loan in the reporting period

• The figure in column (6) is then transferred to detail 601.

7.2.3. Detail 207


• Column (2) is filled by specifying the city (DATI II) in which the building

with strata-title rights or land with building are located.


• Column (5) represents the difference between column (3) and the column (4)

for each unit.

• Line No. II (AYD) is less than or equal to 15% of SAK Own-Equity in the

current period.

7.24 Details 208

The columns on these details are filled in accordance with the information provided

in the format.

7.25 Details 209

The columns on these details are filled in accordance with the information provided

in the format.

7.26 Details 301


• For details of the creditor, the creditor’s to be detailed are those that have

claims to the company as much as 5% or more of the total claims payable.

Debtor that has claims of less than 5% of the total claims payable will be

categorized in "Other/Miscellaneous”.

• The figure in columns (7) is transferred to details 601.

7.27 Details 302



claims to the company as much as 5% or more of the total coinsurance

payable. Debtor that has claims of less than 5% of the total coinsurance

payable will be categorized in "Other/Miscellaneous”.


7.28 Details 303



claims to the company as much as 5% or more of the total reinsurance

payable. Debtor that has claims of less than 5% of the total reinsurance



7.29 Details 304



claims to the company as much as 5% or more of the total commission

payable. Debtor that has claims of less than 5% of the total commission



7.30 Details 305


• Column (2) is filled with information of cost totalling of 5% or more of the

total costs accrued. Costs in the amount of less than 5% of the total costs

accrued would simply be categorized in the "Other/Miscellaneous".

7.30 Details 306


• Column (2) is filled with information debt totalling of 5% or more of the total

liabilities. Debt in the amount of less than 5% of the total liability would

simply be categorized in the "Other/Miscellaneous".

7.32 Details 401

The columns on these details are filled in accordance with the information


7.33 Details 402



7.34 Details 403



7.35 Details 501

• These details are the details of the underwriting income as stated in the

Comprehensive Profit/Loss Statement, but in this case the underwriting

income is specified for new products and continued premium, both

individuals and groups, so that the total in line 18 column (12) will be equal

to the amount of underwriting income in Comprehensive Profit/Loss

Statement on page 2.

7.36 Details 502

• The investment yield in these details include the yields of investment already

realized (net investment yield) and unrealized (unrealized gain). But the

yields of these investments shall be filled out into the Comprehensive

Profit/Loss Statement that are adjusted with the prevailing PSAK (accounting

standards).


Example: General Insurance Company has corporate bonds with coupon

interest payment and valuation is based on market price. Thus, this type of

investment will provide yields that can be categorized into two, i.e. interest

(coupon) and gain due to rising market prices. Column (7) is filled with the

interest earned in the reporting period and the gain (Realized gains and

unrealized gain).

7.37 Details 503

For other income, the information specified shall be income in the amount of 5%

or more of the total other income. Income of less 5% of total other income would

be categorized as “Others/Miscellaneous”.

7.38 Details 504

In this details, each insurance branch shall be specified in terms of types of

payment of claims/benefits, such as: at the end of contract, single value, upon

death, etc.

7.39 Details 505

For details on yield (expense), information specified shall be the yield (expense) in

the amount of 5% or more of the total yield (expense). Yield (expense) of less than

5% of the total yield (expense) would be categorized as "Others/Miscellaneous".

7.40 Details 506

Columns in these details are filled in accordance with the information provided in

the format.

7.41 Details 601

• Definition of Current Assets and Current Liabilities are all assets and

liabilities of life insurance company which have a term of less than or equal

to one year from the date of reporting.

• The figure is then filled in into the Additional Financial Statement point 1a

and 1b (Liquidity Ratio).

III. ADDITIONAL FINANCIAL STATEMENT

1. Guarantee Fund Report

The Guarantee Fund Report intended use is to monitor company’s compliance in

fulfilling the minimum requirement of guarantee fund that serves as the last guarantee

for policyholders if the company is liquidated. In the report, details are provided for

the total amount of guarantee funds, deposit certificates, and calculation of the

minimum guarantee fund required.

The summary of guarantee fund, calculation of guarantee fund adequacy, and details

of guarantee fund closing position is filled out according to the format.

The amount of required paid-up capital that is used in the calculation of guarantee

funds is the amount of required paid-up capital when establishing the Life Insurance

business.

For Life Insurance Company, the basis to determine additional guarantee funds shall

be the net premium for all types of insurance products marketed by the company

2. Financial Soundness Ratio Other Than MMBR

This ratio is an additional ratio in calculating the company’s financial soundness level,

consisting of:

a. Liquidity ratio, to identify the company’s capacity to meet short-term financial

liability when due by using the available current assets.

b. Investment adequacy ratio, to measure the company’s capacity in paying potential

claims.

c. Match between investment yields and net premium income ratio, to compare

company asset originating from investment and net income from received

premium.

d. Claim expenses, business expenses, and commission ratio, to calculate the size of

the received revenue from premium after deducting expenses.

Details of the ratios are filled out according to the information provided in the formats.

3. Education and Training Ratio

For this detail, the followings apply:

I. Education and Training Cost § Column (2) is filled with the name of the education and training that are planned to

be held or have been budgeted.

§ Column (3) is filled with the budgeting of the education and training cost for one

year.

§ Column (4) is filled with the realization of education and training costs

cumulatively up to the reporting period.

II. Education and Training Ratio § Column (3) is filled with the budgeted cost for staff, directors, and commissioners

cost as well as the budgeted education and training cost for each users, namely

staff, directors, and commissioners, within the one year:

§ Column (4) is filled with the realized cost of the staff, directors, and

commissioners, as well as the realized cost of the education and training for each

users, namely staff, directors, and commissioners, that has been conducted up to the

period of report within the year.

4. Matching Assets and Liabilities

Matching assets and liabilities based on currency and maturity is required to

identify the difference between values of asset and liabilities in foreign currency,

as well as the fluctuation of foreign currency exchange to rupiah. The columns

in this detail are filled based on SAK value.

5. Details of Premium Income and Claim Expenses based on Distribution Channel

The columns in this detail are filled according to the information provided in the

format.

Stipulated in Jakarta

On 27 August 2013

CHIEF EXECUTIVE OF NON-

BANK FINANCIAL INDUSTRY

SUPERVISION OF

FINANCIAL SERVICES

AUTHORITY

Signed.

FIRDAUS DJAELANI

This copy conforms the original

Head of Legal Assistance Division of

Financial Services Authority,

Signed.

Mufli Asmawidjaja

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